Questions and Answers: Flu season hits U.S.

Jan. 11, 2013
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Flu season advisory / flu.gov

by Dan Vergano, USA TODAY

by Dan Vergano, USA TODAY

The flu season is off to a roaring start with a bug that looks "particularly severe," according to the Food and Drug Administration. What do you need to know about the flu and how to keep from getting it? Here are a few common questions and answers from flu experts and public health officials.:

Q: What are the symptoms?

A: Misery, basically. Flu comes on suddenly, accompanied by fever and chills, coughing, sore throats, muscle aches, fatigue and headaches. Nausea and diarrhea are more common in children. A bad cold makes daily life rotten, but a bad flu makes it really miserable.

Q: Why is it so bad this year?

A: Flu is unpredictable, and its year-to-year spread depends on the strain of the virus, how well vaccinations match the bug (and how many people get vaccinated) and chance. This year's vaccine is actually a good match to the strain that is the dominant kind now, says Columbia University virus expert Vincent Racaniello. Cases only began to pick up in the last two weeks, suggesting the peak of the season may be upon us now, a bit early.

The flu season started about four to five weeks early this year, says Tom Skinner of the federal Centers for Disease Control and Prevention in Atlanta. We are on the fifth week right now of the typical 12-week winter flu season.

Q: Who is most at risk from the flu?

A: Most cases of the flu are mild and resolve within two weeks. The elderly are the most likely to die from flu cases that cause severe complications, such as pneumonia. Flu can also trigger severe asthma attacks and worsen chronic heart disease. Even healthy teenagers and young adults can die from complications of the flu, although young children and people with compromised immune systems face a much higher risk. Kids or teens receiving long-term aspirin therapy for blood vessel inflammation also are at higher risk of complications, such as Reye's syndrome, which causes swelling of the brain and liver, from the flu.

Q: Are there vaccine shortages?

A: Skinner says the CDC has only seen spot shortages, not large-scale ones, "so you may have to shop around" to find a pharmacy with shots left.Manufacturers made 135 million doses and about 128 million have been distributed, with 112 million people inoculated by around New Year's Day. Typically about 35% of the population is vaccinated every year and this year looks similar.

Q: Is it too late to get a vaccine shot?

A: Not at all. Go get a shot. More important, get your child vaccinated, if they haven't been already. For the first vaccination, children under 2 need two shots, spaced four weeks apart, but even one shot helps. Antibodies to the flu can appear within days after vaccination and they peak in the weeks thereafter, so there is time.

Q: What about prevention? What can I do to not get the flu in the first place?

A: Get the flu vaccine. Wash your hands often, or use an alcohol-based hand cleanser, and keep them away from your face. Flu bugs can live for two to eight hours on surfaces after someone coughs them out. Don't go back to work until 24 hours after your fever breaks to prevent infecting other people.

Q: Can I get the flu even after I get the shot?

A: Yes. The CDC estimates the flu vaccine is about 60% effective, on average. "Even if it isn't perfect, and we wish it was a lot better, it is a lot better than taking your chances and getting sick," Racaniello says. Moreover, enough people getting even an imperfect vaccine can break the back of an outbreak by limiting its odds of spreading. And people who have been vaccinated typically have weaker bouts with the flu, even if they do get sick.

One thing to keep in mind is that if you pick up a cough or a sore throat even though you have been vaccinated, it doesn't mean the vaccination failed. There are plenty of other bugs, such as whooping cough, out there that might be making you sick, instead of influenza.

Q. Why don't we have a better flu shot?

A. Because the current flu vaccine is still made with 1950s-era technology, says Michael Osterholm, director of the Center for Infectious Disease Research and Policy and a professor at the University of Minnesota School of Public Health.

The currently available flu vaccines stimulate immunity by including proteins found on the outer coating of the influenza virus. But these proteins change from season to season, requiring scientists to update the vaccine each year. A better vaccine would stimulate immunity with components of the virus that don't change, providing protection for a decade or more, says William Schaffner, a professor at the Vanderbilt University School of Medicine. Early, phase 1 trials of a universal flu vaccine are already underway, Schaffner says.

Q: If I get the symptoms, at what point do I see the doctor?

A: In most cases, you should stay home and avoid contact with other people, according to the FDA. But if things get bad, do go see a physician. The elderly, young children and people with weak immune systems are particularly vulnerable, so they should see a doctor if they have flu symptoms.

Q: If I start feeling the symptoms, do I need Tamiflu or Relenza?

A: Physicians can prescribe these drugs, which block the influenza virus's ability to spread from cell to cell. The three major flu strains in this year's outbreak are treatable with these drugs.